Outbreak of Achromobacter Xylosoxidans and Ochrobactrum Anthropi Infections After Prostate Biopsies, France, 2014

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2016 Jul 20

PMID 27434277

Citations 10

Authors

Skerdi Haviari

Pierre Cassier

Cedric Dananche

Monique Hulin

Olivier Dauwalder

Olivier Rouviere

Xavier Bertrand

Michel Perraud

Thomas Benet

Philippe Vanhems

Affiliations

Soon will be listed here.

Abstract

We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13-October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case-control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.

Citing Articles

The in vitro synergistic and antibiofilm activity of Ceftazidime/avibactam against Achromobacter species recovered from respiratory samples of cystic fibrosis patients.

Mataraci-Kara E, Damar-Celik D, Ozbek-Celik B Eur J Clin Microbiol Infect Dis. 2024; 44(3):587-596.

PMID: 39702543 DOI: 10.1007/s10096-024-05017-0.

Metabarcoding using nanopore sequencing enables identification of diverse and zoonotic vector-borne pathogens from neglected regions: A case study investigating dogs from Bhutan.

Huggins L, Namgyel U, Wangchuk P, Atapattu U, Traub R, Colella V One Health. 2024; 19:100839.

PMID: 39005237 PMC: 11238191. DOI: 10.1016/j.onehlt.2024.100839.

Achromobacter cluster related to COVID-19 supply chain issues.

Scales M, Gallagher M, Haessler S, Lindsey K, Maryanski M, Mathew M Antimicrob Steward Healthc Epidemiol. 2024; 4(1):e67.

PMID: 38698950 PMC: 11062781. DOI: 10.1017/ash.2024.66.

Genomics of (newly named ) reveals a new subgroup.

Li S, Huang Y, Chen J, Lai C, Mao Y, Huang Y Microb Genom. 2021; 7(8).

PMID: 34448692 PMC: 8549353. DOI: 10.1099/mgen.0.000626.

The Genus as Major Opportunistic Pathogens.

Ryan M, Pembroke J Microorganisms. 2020; 8(11).

PMID: 33207839 PMC: 7696743. DOI: 10.3390/microorganisms8111797.

References

Galosi A, Muzzonigro G, Lacetera V, Mazzucchelli R . Specimen orientation by marking the peripheral end: (potential) clinical advantages in prostate biopsy. Prostate Cancer. 2011; 2011:270403. PMC: 3200280. DOI: 10.1155/2011/270403. View

Dumford 3rd D, Suwantarat N, Bhasker V, Kundrapu S, Zabarsky T, Drawz P . Outbreak of fluoroquinolone-resistant Escherichia coli infections after transrectal ultrasound-guided biopsy of the prostate. Infect Control Hosp Epidemiol. 2013; 34(3):269-73. DOI: 10.1086/669512. View

Christenson J, Pavia A, Seskin K, Brockmeyer D, Korgenski E, Jenkins E . Meningitis due to Ochrobactrum anthropi: an emerging nosocomial pathogen. A report of 3 cases. Pediatr Neurosurg. 1998; 27(4):218-21. DOI: 10.1159/000121256. View

Liss M, Johnson J, Porter S, Johnston B, Clabots C, Gillis K . Clinical and microbiological determinants of infection after transrectal prostate biopsy. Clin Infect Dis. 2014; 60(7):979-87. DOI: 10.1093/cid/ciu1129. View

Olshtain-Pops K, Block C, Temper V, Hidalgo-Grass C, Gross I, Moses A . An outbreak of achromobacter xylosoxidans associated with ultrasound gel used during transrectal ultrasound guided prostate biopsy. J Urol. 2010; 185(1):144-7. DOI: 10.1016/j.juro.2010.08.093. View

Ezzedine H, Mourad M, Van Ossel C, Logghe C, Squifflet J, Renault F . An outbreak of Ochrobactrum anthropi bacteraemia in five organ transplant patients. J Hosp Infect. 1994; 27(1):35-42. DOI: 10.1016/0195-6701(94)90066-3. View

Hutchinson J, Runge W, Mulvey M, Norris G, Yetman M, Valkova N . Burkholderia cepacia infections associated with intrinsically contaminated ultrasound gel: the role of microbial degradation of parabens. Infect Control Hosp Epidemiol. 2004; 25(4):291-6. DOI: 10.1086/502394. View

Siebor E, Llanes C, Lafon I, Ogier-Desserrey A, Duez J, Pechinot A . Presumed pseudobacteremia outbreak resulting from contamination of proportional disinfectant dispenser. Eur J Clin Microbiol Infect Dis. 2007; 26(3):195-8. DOI: 10.1007/s10096-007-0260-1. View

Amoureux L, Bador J, Fardeheb S, Mabille C, Couchot C, Massip C . Detection of Achromobacter xylosoxidans in hospital, domestic, and outdoor environmental samples and comparison with human clinical isolates. Appl Environ Microbiol. 2013; 79(23):7142-9. PMC: 3837737. DOI: 10.1128/AEM.02293-13. View

10.

Reina J, Antich M, Siquier B, Alomar P . Nosocomial outbreak of Achromobacter xylosoxidans associated with a diagnostic contrast solution. J Clin Pathol. 1988; 41(8):920-1. PMC: 1141632. DOI: 10.1136/jcp.41.8.920-c. View

11.

Steensels D, Slabbaert K, De Wever L, Vermeersch P, van Poppel H, Verhaegen J . Fluoroquinolone-resistant E. coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy--should we reassess our practices for antibiotic prophylaxis?. Clin Microbiol Infect. 2011; 18(6):575-81. DOI: 10.1111/j.1469-0691.2011.03638.x. View

12.

Tal R, Livne P, Lask D, Baniel J . Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy. J Urol. 2003; 169(5):1762-5. DOI: 10.1097/01.ju.0000061280.23447.29. View

13.

Cholley P, Gbaguidi-Haore H, Bertrand X, Thouverez M, Plesiat P, Hocquet D . Molecular epidemiology of multidrug-resistant Pseudomonas aeruginosa in a French university hospital. J Hosp Infect. 2010; 76(4):316-9. DOI: 10.1016/j.jhin.2010.06.007. View

14.

Mattos F, Saraiva F, Angotti-Neto H, Passos A . Outbreak of Ochrobactrum anthropi endophthalmitis following cataract surgery. J Hosp Infect. 2013; 83(4):337-40. DOI: 10.1016/j.jhin.2012.11.027. View

15.

Shen P, Zhu Y, Wei W, Li Y, Yang J, Li Y . The results of transperineal versus transrectal prostate biopsy: a systematic review and meta-analysis. Asian J Androl. 2011; 14(2):310-5. PMC: 3735101. DOI: 10.1038/aja.2011.130. View

16.

El-Hakim A, Moussa S . CUA guidelines on prostate biopsy methodology. Can Urol Assoc J. 2010; 4(2):89-94. PMC: 2845759. DOI: 10.5489/cuaj.10021. View

17.

Taylor A, Murphy A . Preprostate Biopsy Rectal Culture and Postbiopsy Sepsis. Urol Clin North Am. 2015; 42(4):449-58. DOI: 10.1016/j.ucl.2015.06.005. View

18.

Loeb S, Vellekoop A, Ahmed H, Catto J, Emberton M, Nam R . Systematic review of complications of prostate biopsy. Eur Urol. 2013; 64(6):876-92. DOI: 10.1016/j.eururo.2013.05.049. View

19.

Tena D, Carranza R, Barbera J, Valdezate S, Garrancho J, Arranz M . Outbreak of long-term intravascular catheter-related bacteremia due to Achromobacter xylosoxidans subspecies xylosoxidans in a hemodialysis unit. Eur J Clin Microbiol Infect Dis. 2005; 24(11):727-32. DOI: 10.1007/s10096-005-0028-4. View

20.

Gillespie J, Arnold K, Noble-Wang J, Jensen B, Arduino M, Hageman J . Outbreak of Pseudomonas aeruginosa infections after transrectal ultrasound-guided prostate biopsy. Urology. 2007; 69(5):912-4. DOI: 10.1016/j.urology.2007.01.047. View